1. Field of the Invention
The present invention relates to systems and methods for assessing and training automobile drivers, and in particular, driver with potential driving impairments.
2. Description of Related Art
Various techniques, systems and methods are available for providing driver education and training. Most driver training systems and methods employ actual, behind the wheel driver training as at least one component. Such driver training may or may not be supplemented with classroom instruction.
Also known are driving simulators in which images are displayed on a display device. In such simulators a steering wheel, brake and accelerator are typically connected in a feedback loop and under computer control the image displayed varies as a function of the driver's operation those components. Additional views, such as left side views, right side views and rear views may be provided within separate windows on the display device, or using separate display devices for views in addition to views simulating a forward view.
U.S. Pat. No. 6,227,862, Harkness, May 8, 2001, discloses a system and method for providing driver training and also education focused on various areas that address driving and lifestyle skills. The six areas addressed are i) lifestyle, ii) risk and benefit perception, iii) visual search, iv) speed adjustment, v) space management and vi) hazard recognition. This system is designed to address the driver training needs of teen drivers, the population of drivers having the highest accident rate in the United States.
Driving ability is also a critical issue for senior drivers and other drivers experiencing a loss of or impairment in their driving skills, though the issues relating to senior driving have many societal implications for an aging population such as exists in the United States and many other industrialized nations.
Elderly people have higher rates of fatal crashes per mile driven, per 100,000 people, and per licensed driver than any other group, except young drivers. A problem is that elderly drivers don't deal as well as younger ones with complex traffic situations, and multiple-vehicle crashes at intersections increase markedly with age. Elderly drivers are more likely to get traffic citations for failing to yield, turning improperly, and running stop signs and red lights.
These issues are present in the elderly because of various impairments to driving ability. Visual acuity is the most obvious area of concern in this regard. Elderly drivers may experience impairments to their vision, from medical causes such as cataracts, glaucoma, or simply accentuated levels of near- or far-sightedness. Even where vision is normal, or can be corrected to normal, a senior may have lost some contrast sensitivity (the ability to detect sharp borders or slight changes in lighting), which is also critical to driving, particularly to driving at night.
Hearing loss among elderly drivers is another common physical impairment to driving, making the driver less likely to hear important auditory cues to driving, such as traffic noises, sirens, honking horns and the like. This is compounded in situations where drivers may be unaware of the loss of hearing.
Another potential impairment to driving ability in the elderly is the loss of range of motion. Arthritis, muscle degeneration, Parkinson's disease, and other health problems can decrease the older driver's ability to perform all the movements of driving and to respond quickly to emergencies. A driver may notice slower response to unexpected situations, such as trouble moving foot from gas to brake pedal or confusing the two pedals. For some drivers, it becomes harder to turn around to check over shoulder while backing up or changing lanes.
In some cases, the elderly driver may reach a stage where he or she is easily distracted or finds it hard to concentrate while driving. Many medications that are more commonly used by the elderly will affect the driver in such ways. These affects are highly variable from person to person, however, and may depend on the use of other medications, or general physical condition.
Car accidents are also more dangerous for seniors than for younger people, and a frail driver is more likely to be seriously hurt, more likely to require hospitalization, and more likely to die than a younger person involved in a similar car accident. Elderly people are not only more susceptible than younger people to medical complications following motor vehicle crash injuries, they are also more likely to die from their injuries. Based on the U.S. Department of Transportation's Fatality Analysis Reporting System, people 65 years and older represented 13 percent of the population in 1996 and 17 percent of motor vehicle deaths.
While safe driving is an important issue, everyone ages differently, and some people are able to retain a high level of driving ability into their seventies and eighties. The independence provided by driving is a valued element of the perception of quality of life for many seniors. Many seniors will view any loss of driving privileges as a loss of freedom. In many families, the decision to restrict the driving of an elderly family member is very difficult. In some cases it may be necessary to involve the driver's doctor as a trusted person for providing impartial advice on health issues that may affect driving. However, there is sometimes little or no motivation for an older existing driver to learn new safety skills, unless the decline in there abilities can be documented for them. Thus, while certain safety skills may be taught to improve the ability of the senior driver, there must be a recognition by the driver of what his diminished abilities are.
Presently, where a driver faces some physical or other impairment, a third party may be required to help assess the drivers driving ability, for instance, by testing vision, reflexes, strength, attention, and other factors. In the case of seniors, recommendations to the driver or the driver's family member are often made regarding placing restrictions or limitations on the driver's actions, or, deciding to stop driving altogether. In a commercial setting a visual cognition impairment observed in an employee driver may give rise to concern and the need for assessment as part of controlling liability.
Alternatively, in many states the Department of Motor Vehicles, Veterans Administration, or other vocational or rehabilitation center might be contacted. All of these options can be intimidating and threatening, particularly to a senior driver already facing concerns about frailty or diminishing cognitive abilities, and the driver may thus be reluctant to undertake such a visit for fear that their driving privileges could be removed.
Some seniors, alternatively, are aware of their own aging process, and may become nervous or tentative in driving. Many seniors give up driving voluntarily, perhaps unnecessarily. When a senior stops driving, this may presents a situation where an additional burden is placed on family or caregivers, as the senior is no longer able to conduct the normal chores of modern living, like visiting friends, shopping or attending various appointments. In such situations, it may be desirable to keep the senior driving, if this can be done under the safest possible, even if somewhat restricted, situations. Restrictions may be to limit driving to certain times of day or to driving only in familiar areas. The motivation of the senior driver to remain driving may again depend on some documented information regarding the extent of their remaining abilities.
The fact of the gradual impairment in driving ability with age, and that some elders become a high risk for road accidents, also creates a problem for policy planners, who must balance the social costs and benefits of senior driving. With the aging of the baby boomers, and the increasing life expectancy, aging drivers will become an issue of greater and greater concern to society. Persons 65 years old and older make up 13 percent of the population. The states with the highest percentage of older persons are Florida, 18 percent; Pennsylvania, 16 percent; Rhode Island, 16 percent; West Virginia, 15 percent; and Iowa, 15 percent. States with the lowest percentage of older persons are: Alaska, 5 percent; Utah, 9 percent; Texas, 10 percent; Georgia, 10 percent; Colorado, 10 percent. By 2030, elderly people are expected to represent 20 percent of the population in the United States.
Some communities provide alternatives to driving for seniors, inexpensive shuttles or buses, taxi vouchers, etc., but these all come at a cost, either to the individual or to the community. In some states the Department of Motor Vehicles have developed programs to evaluate individual driving abilities or may offer special licensing alternatives.
A further cost is the cost of insuring senior drivers. As they are subject to more accidents, the rates for insuring senior drivers will naturally be increased as they age. A blanket policy, however, fails to distinguish among the truly impaired drivers and those that may be driving safely into their eighties. One solution is to regularly test senior drivers, or require that at certain stages they take a refresher driving course, possibly a course tailored to the issues and concerns of elderly drivers. Regular check-ups for hearing, vision and general health, when reported to the insurance company, can provide some basis for continued insurability.
Policies can also be adjusted to reflect these concerns. AAA encourages every state to have a medical advisory or review board comprised of physicians and health care professionals to assess driver capabilities. AAA's Basic Best Practices recommends that these boards develop medical guidelines for licensing in the state and that they be given the authority to recommend customized or restricted licenses that allow driving privileges under certain conditions.
As an alternative, these individuals can contact a local driving school to assess his or her skills. The AARP has a Driver Safety Program taught as a classroom course designed for older drivers to help them hone their skills and avoid accidents and traffic violations. Website features information on the classess and on senior driving in general, including FAQs, a driving IQ test, a close call test, and directions to a driving course nearby.
Physicians can also refer people with mild cognitive problems to a hospital or rehabilitation facility with a driver evaluation program. The individual will then go through a series of tests to measure critical driving skills. The “Physician's Guide to Assessing and Counseling Older Drivers”, developed by the American Medical Association in cooperation with the National Highway Traffic Safety Administration, assists physicians in evaluating the ability of their older patients to operate a motor vehicle safely. This 226-page guide includes checklists for vision and motor skills.
However, notwithstanding such training and education opportunities, over the years there have been no significant advances in the ability to monitor the declining driving abilities of existing drivers. It would be desirable to be able to easily and quickly assess the decline in certain motor skill and cognitive abilities of senior drivers, and to use that assessment in designing a program for assisting the individual senior in overcoming their particular areas of impairment, and thus improving their driving abilities. It is believed that newer techniques are necessary to screen such drivers, and to provide a mechanism to train drivers with declining skills to learn newer or adaptive strategies tailored to their remaining abilities that will result in reductions in accident rates.